Bioactive Glasses as Antibacterial Agents: A Review

Bioactive glasses (BGs) have evolved significantly since their discovery in the late 1960s, transitioning from simple biocompatible materials to multifunctional platforms capable of modulating tissue response at the molecular level. BGs can dissolve in physiological environments, precipitate hydroxyapatite, and release therapeutic ions, establishing them as third-generation biomaterials. Among emerging functionalities, antibacterial properties have attracted considerable interest, driven by the need for materials capable of preventing and combating infections in biomedical applications. Early compositions, such as 45S5 and S53P4, exhibited antibacterial effects mainly via pH changes, whereas more recent formulations incorporate antibacterial ions to achieve stronger and tunable effects. Metallic ions – including silver, copper, zinc, strontium, cerium, and boron – can confer bactericidal activity, acting through membrane disruption, enzyme interference, oxidative stress, or inhibition of DNA replication. Modifying BG compositions allows the creation of materials combining osteogenic and antibacterial functions, enabling applications in bone scaffolds, implant coatings, and wound healing. This review summarizes recent advances in the design, mechanisms, and biological performance of antibacterial BGs, emphasizing translational potential. By integrating findings from in vitro, in vivo, and clinical studies, we highlight the strengths and challenges of BGs that couple regenerative capability with antibacterial action, offering insights for future biomedical development.